Endoscopic retrograde cholangiopancreatogram (ercp)

ERCP is done to:

• Find gallstones or diseases of the liver, bile ducts, or pancreas.
• Remove gallstones from the common bile duct if they are causing problems. These may include a blockage (obstruction), inflammation or infection of the common bile duct (cholangitis), or pancreatitis.
• Open a narrowed bile duct or insert a drain.
• Get a tissue sample for more testing (biopsy).
• Measure the pressure inside the bile ducts (manometry).

This test can be done in the hospital, an endoscopy center, or a surgery center. You may have to stay overnight if your doctor takes out gallstones or places a stent during the test. Otherwise, you can go home after the test.

Your throat may be numbed with an anesthetic spray, gargle, or lozenge to relax your gag reflex. This makes it easier to insert a thin, flexible fiber-optic endoscope (scope). Shortly before the test begins, an intravenous (I.V.) line will be placed in a vein in your arm. You will get pain medicine and a sedative through the I.V. during the test. You may also get an antibiotic through the I.V.

You will need to lie on your left side. Your head will be tilted slightly forward. A mouth guard may be inserted to protect your teeth from the scope. The scope's tip will be lubricated. The doctor will guide it into your mouth while gently pressing your tongue out of the way. You may be asked to swallow to help move the tube along. The scope is no thicker than many foods you swallow.

When the scope is in your esophagus, your head will be tilted upright to help the scope slide down. Then your doctor will slowly move the scope into your stomach and duodenum. Your doctor looks at all three of these areas as the scope moves forward. When it reaches your duodenum, you will be turned over to lie flat on your belly.

A small amount of air will be injected through the scope. This makes it easier for the doctor to see. The doctor will move the scope forward until it reaches the point where the ducts from the pancreas and gallbladder drain into the duodenum. A thin tube called a catheter is then passed through the scope into that area. Then contrast material is injected into the bile or pancreatic ducts. Several X-rays are taken. You will stay on your belly until the X-rays are ready to view. If needed, the doctor may take more X-rays.

The doctor may insert small tools through the scope. This allows the doctor to take a tissue sample, remove a gallstone, open a narrowed bile duct, or place a stent.

When the test is done, the scope is slowly withdrawn.

After the test

After the test, you will be observed in a recovery room. If your throat was numbed before the test, you will not be allowed to eat or drink until your throat is no longer numb. You will need to be able to swallow without choking. You can then eat and drink normally.

If your doctor removed a gallstone or placed a stent during the test, you may need to stay a night in the hospital. You cannot drive or return to work for 24 hours.

You may need to stop eating and drinking before the day of the procedure. If this is the case, your doctor will tell you what to do.

If your doctor prescribed antibiotics before the test, take them as directed. You need to take the full course of antibiotics.

• Tell your doctor if you are allergic to any dyes, including iodine.
• If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your procedure. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.

Your doctor may be able to tell you about some findings right after the test. But the medicines used to relax you for the test may impair your memory. So your doctor may tell you to call the next day for your results.